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Khazaal Y, El Abiddine FZ, Penzenstadler L, Berbiche D, Bteich G, Valizadeh-Haghi S, Rochat L, Achab S, Khan R, Chatton A. Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12099. [PMID: 36231401 PMCID: PMC9566183 DOI: 10.3390/ijerph191912099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy. METHODS We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants. RESULTS Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use. CONCLUSIONS Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.
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Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, 1015 Lausanne, Switzerland
- Department of Psychiatry and Addictology, Montréal University, Montréal, QC H3T 1J4, Canada
| | - Fares Zine El Abiddine
- Laboratory Psychological and Educational Research, Department of Psychology, University Djillali Liabes of Sidi Bel Abbes, Sidi Bel Abbes 22000, Algeria
| | - Louise Penzenstadler
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Djamal Berbiche
- Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
| | - Ghada Bteich
- Faculty of Public Health, Lebanon University, Tripoli P.O. Box 6573/14, Lebanon
| | - Saeideh Valizadeh-Haghi
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lucien Rochat
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Sophia Achab
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Affiliated to Bahria University Islamabad, Abbottabad 22010, Pakistan
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
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Impact of Short-Term Intensive-Type Cognitive Behavioral Therapy Intervention on Internet Addiction among Chinese College Students: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095212. [PMID: 35564611 PMCID: PMC9099546 DOI: 10.3390/ijerph19095212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/10/2022]
Abstract
The object of this study is to examine the effects of a short-term intensive-type Cognitive Behavioral Therapy (CBT) intervention to prevent internet addiction among Chinese college students. We conducted a randomized controlled trial applying a group counseling intervention program based on CBT. Data included 21 participants in the intervention group and 22 participants in the control group. The results showed that the intervention program reduced college students’ internet addiction symptoms and procrastination and improved their sense of coherence. Regarding the sustained effect, internet addiction symptoms decreased and perceived social support from significant others improved in college students. However, the intervention program did not significantly reduce their average daily internet use time and psychological stress. Overall, this study developed a short-term intensive-type intervention program based on CBT theory, which is complementary for Chinese college students with internet addiction.
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Ballou N, Van Rooij AJ. The relationship between mental well-being and dysregulated gaming: a specification curve analysis of core and peripheral criteria in five gaming disorder scales. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201385. [PMID: 34084538 PMCID: PMC8150039 DOI: 10.1098/rsos.201385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Gaming disorder (also known as dysregulated gaming) has received significant research and policy attention based on concerns that certain patterns of play are associated with decreased mental well-being and/or functional impairment. In this study, we use specification curve analysis to examine analytical flexibility and the strength of the relationship between dysregulated gaming and well-being in the form of general mental health, depressive mood and life satisfaction. Dutch and Flemish gamers (n = 424) completed an online survey containing five unique dysregulated gaming measures (covering nine scale variants) and three well-being measures. We find a consistent negative relationship; across 972 justifiable regression models, the median standardized regression coefficient was -0.39 (min: -0.54, max: -0.19). Data show that the majority of dysregulated gaming operationalizations converge upon highly similar estimates of well-being. However, variance is introduced by the choice of well-being measure; results indicate that dysregulated gaming is more strongly associated with depressive mood than with life satisfaction. Weekly game time accounted for little to no unique variance in well-being in the sample. We argue that research on this topic should compare a broad range of psychosocial well-being outcomes and explore possible simplifications of the DSM-5 gaming disorder criteria. Given somewhat minute differences between dysregulated gaming scales when used in survey-based studies and largely equivalent relationships with mental health indicators, harmonization of measurement should be a priority.
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Ko CH, Király O, Demetrovics Z, Chang YM, Yen JY. Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria. J Behav Addict 2020; 9:572-588. [PMID: 33011711 PMCID: PMC8943683 DOI: 10.1556/2006.2020.00058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them. METHODS A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified. RESULTS Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies. CONCLUSION The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.
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Affiliation(s)
- Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Rd., 807, Kaohsiung City, Taiwan,Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482 San-Ming Rd., 812, Kaohsiung City, Taiwan,Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shi-Chuan 1st Rd., 807, Kaohsiung City, Taiwan,Corresponding author. E-mail:
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Yun-Ming Chang
- Department of Psychology, Minnan Normal University, China
| | - Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Rd., 807, Kaohsiung City, Taiwan,Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shi-Chuan 1st Rd., 807, Kaohsiung City, Taiwan,Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, 812, Taiwan
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Pontes HM, Schivinski B, Brzozowska-Woś M, Stavropoulos V. Laxer Clinical Criteria for Gaming Disorder May Hinder Future Efforts to Devise an Efficient Diagnostic Approach: A Tree-Based Model Study. J Clin Med 2019; 8:jcm8101730. [PMID: 31635431 PMCID: PMC6832569 DOI: 10.3390/jcm8101730] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/10/2019] [Accepted: 10/17/2019] [Indexed: 12/13/2022] Open
Abstract
Internet Gaming Disorder (IGD) has been recognized in May 2013 and can be evaluated using the criteria developed by American Psychiatric Association (APA). The present study investigated the role each IGD criteria plays in diagnosing disordered gaming. A total of 3377 participants (mean age 20 years, SD = 4.3 years) participated in the study. The data collected was scrutinized to detect patterns of IGD using Conditional Inference Tree (Ctree), a sophisticated machine algorithm. Participants provided basic sociodemographic information and completed the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF). The results identified classes of IGD-related symptoms, indicating that endorsing ‘withdrawal’ and ‘loss of control’ increases the probability of disordered gaming by 77.77% while endorsement of ‘withdrawal’, ‘loss of control’ and ‘negative consequences’ increases the probability of disordered gaming by 26.66%. Moreover, lack of endorsement of ‘withdrawal’ and endorsement of ‘preoccupation’ increases the likelihood of disordered gaming by 7.14%. Taken together, the results obtained illustrate that different IGD criteria can present with different clinical weighing as unique diagnostic roles in the development of disordered gaming can be evidenced by each criterion. Moreover, the present findings help inform future revisions of diagnostic manuals and helps enhancing the assessment of IGD in the future. Additional research and clinical implications are discussed.
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Affiliation(s)
- Halley M Pontes
- Division of Psychology, School of Medicine, University of Tasmania, Launceston, TAS 7250, Australia.
- The International Cyberpsychology and Addictions Research Laboratory (iCARL), University of Tasmania, Launceston, TAS 7250, Australia.
| | - Bruno Schivinski
- The International Cyberpsychology and Addictions Research Laboratory (iCARL), University of Tasmania, Launceston, TAS 7250, Australia.
- RMIT University, School of Media and Communication, 124 La Trobe St, Melbourne, VIC 3000 , Australia.
| | - Magdalena Brzozowska-Woś
- Gdansk University of Technology, Department of Marketing, Ul. Narutowicza 11/12, 80-233 Gdansk, Poland.
| | - Vasileios Stavropoulos
- The International Cyberpsychology and Addictions Research Laboratory (iCARL), University of Tasmania, Launceston, TAS 7250, Australia.
- Victoria University, School of Psychology, College of Health and Biomedicine, Ballarat Road, Footscray, VIC 3011, Australia.
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Throuvala MA, Griffiths MD, Rennoldson M, Kuss DJ. School-based Prevention for Adolescent Internet Addiction: Prevention is the Key. A Systematic Literature Review. Curr Neuropharmacol 2019; 17:507-525. [PMID: 30101714 PMCID: PMC6712298 DOI: 10.2174/1570159x16666180813153806] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/12/2018] [Accepted: 08/02/2018] [Indexed: 11/23/2022] Open
Abstract
Adolescents' media use represents a normative need for information, communication, recreation and functionality, yet problematic Internet use has increased. Given the arguably alarming prevalence rates worldwide and the increasingly problematic use of gaming and social media, the need for an integration of prevention efforts appears to be timely. The aim of this systematic literature review is (i) to identify school-based prevention programmes or protocols for Internet Addiction targeting adolescents within the school context and to examine the programmes' effectiveness, and (ii) to highlight strengths, limitations, and best practices to inform the design of new initiatives, by capitalizing on these studies' recommendations. The findings of the reviewed studies to date presented mixed outcomes and are in need of further empirical evidence. The current review identified the following needs to be addressed in future designs to: (i) define the clinical status of Internet Addiction (IA) more precisely, (ii) use more current psychometrically robust assessment tools for the measurement of effectiveness (based on the most recent empirical developments), (iii) reconsider the main outcome of Internet time reduction as it appears to be problematic, (iv) build methodologically sound evidence-based prevention programmes, (v) focus on skill enhancement and the use of protective and harm-reducing factors, and (vi) include IA as one of the risk behaviours in multi-risk behaviour interventions. These appear to be crucial factors in addressing future research designs and the formulation of new prevention initiatives. Validated findings could then inform promising strategies for IA and gaming prevention in public policy and education.
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Affiliation(s)
- Melina A. Throuvala
- Address correspondence to this author at the Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, United Kingdom; Tel: +44 (0)115 941 8418; E-mail:
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Khazaal Y, Breivik K, Billieux J, Zullino D, Thorens G, Achab S, Gmel G, Chatton A. Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded-Response Modeling. J Med Internet Res 2018; 20:e10058. [PMID: 30150204 PMCID: PMC6131318 DOI: 10.2196/10058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/24/2018] [Accepted: 05/12/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The 7-item Game Addiction Scale (GAS) has been validated under standard confirmatory factor analysis and exhibits good psychometric properties. Whether this scale satisfies the necessary conditions for consideration by item response theory (IRT) modeling remains unknown. However, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently proposed criteria, in its section 3, to define internet gaming disorder (IGD) to promote research on this possible condition. OBJECTIVE The objective of our study was to (1) analyze GAS in the context of IRT (graded-response) modeling; (2) investigate differential item functioning (DIF), a feature of IRT modeling, in 2 subsamples; and (3) contribute to the ongoing (IGD) debate related to the validity of the DSM-5 criteria using GAS items as a proxy. METHODS We assessed 2 large representative samples of Swiss men (3320 French-speaking and 2670 German-speaking) with GAS. RESULTS All items comprised high discrimination parameters. GAS items such as relapse, conflict, withdrawal, and problems (loss of interests) were endorsed more frequently in more severe IGD stages, whereas items related to tolerance, salience (preoccupation), and mood modification (escape) were endorsed more widely among participants (including in less severe IGD stages). Several DIF effects were found but were classified as negligible. CONCLUSIONS The results of the analyses partly support the relevance of using IRT to further establish the psychometric properties of the GAS items. This study contributes to testing the validity of the IGD criteria, although cautious generalization of our findings is required with GAS being only a proxy of the IGD criteria.
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Affiliation(s)
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Joel Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | | | | | | | - Gerhard Gmel
- Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne Chatton
- Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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Schivinski B, Brzozowska-Woś M, Buchanan EM, Griffiths MD, Pontes HM. Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study. Addict Behav Rep 2018; 8:176-184. [PMID: 30505924 PMCID: PMC6251978 DOI: 10.1016/j.abrep.2018.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/04/2018] [Accepted: 06/20/2018] [Indexed: 12/12/2022] Open
Abstract
Internet Gaming Disorder (IGD) has been recognized by the American Psychiatric Association (APA) as a tentative disorder in the latest fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In order to advance research on IGD, the APA has suggested that further research on the nine IGD criteria to investigate its clinical and empirical feasibility is necessary. The aim of the present study was to develop the Polish the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) and scrutinize the nine IGD criteria empirically. To achieve this, the newly developed IGDS9-SF was examined using a wide range of psychometric methods, including a polytomous Item Response Theory (IRT) analysis to evaluate the measurement performance of the nine IGD criteria. A sample of 3377 gamers (82.7% male, mean age 20 years, SD = 4.3 years) was recruited online for the present study. Overall, the findings obtained confirmed that suitability of the Polish IGDS9-SF to assess IGD amongst Polish gamers given the adequate levels of validity and reliability found. The IRT analysis revealed that the IGDS9-SF is a suitable tool to measure IGD levels above the average; however, criteria “continuation” (item 6), “deception” (item 7), and “escape” (item 8) presented with poor fit. Taken together, these results suggest that some of the diagnostic criteria may present with a different clinical weighting towards final diagnosis of IGD. The implications of these findings are further discussed. The APA diagnostic criteria for IGD was investigated in a large sample of gamers. The construct of IGD was examined via validity analysis and Item Response Theory. The results revealed the suitability of the IGDS9-SF to assess IGD-related symptoms. Each IGD criterion present with distinct clinical diagnostic weighting. The nine IGD criteria need to take into account different clinical weighting.
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Affiliation(s)
- Bruno Schivinski
- Birkbeck, University of London, Department of Management, Malet Street, Bloomsbury, WC1E 7HX London, United Kingdom of Great Britain and Northern Ireland
| | - Magdalena Brzozowska-Woś
- Gdansk University of Technology, Department of Marketing, Ul. Narutowicza 11/12, Gdansk 80-233, Poland
| | - Erin M Buchanan
- Missouri State University, Department of Psychology, 901 S. National Ave, Springfield, MO 65897, USA
| | - Mark D Griffiths
- Nottingham Trent University, International Gaming Research Unit, Psychology Department, 50 Shakespeare Street, Nottingham NG1 4QF, United Kingdom of Great Britain and Northern Ireland
| | - Halley M Pontes
- Nottingham Trent University, International Gaming Research Unit, Psychology Department, 50 Shakespeare Street, Nottingham NG1 4QF, United Kingdom of Great Britain and Northern Ireland
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King DL, Adair C, Saunders JB, Delfabbro PH. Clinical predictors of gaming abstinence in help-seeking adult problematic gamers. Psychiatry Res 2018; 261:581-588. [PMID: 29407726 DOI: 10.1016/j.psychres.2018.01.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 02/06/2023]
Abstract
Research into the effectiveness of interventions for problematic gaming has been limited by a lack of data concerning the clinical characteristics of voluntary treatment-seekers; the nature and history of their gaming problems; and, their reasons for seeking help. The study aimed to identify variables predictive of short-term commitment to gaming abstinence following initial voluntary contact with an online help service. A total of 186 adult gamers with gaming-related problems were recruited online. Participants completed the DSM-5 Internet gaming disorder (IGD) checklist, Depression Anxiety Stress Scales-21, Internet Gaming Cognition Scale, Gaming Craving Scale, and Gaming Quality of Life Scale. A one-week follow up survey assessed adherence with intended gaming abstinence. Abstainers were less likely to have withdrawal symptoms and less likely to play action shooting games. Participants with mood symptoms (40% of the total) reported significantly more IGD symptoms, stronger maladaptive gaming cognitions (e.g., overvaluing game rewards), more previous occurrences of gaming problems, and poorer quality of life. However, mood symptoms did not predict abstinence from or continuation of gaming. Adults with gaming disorder seeking help to reduce their gaming may benefit initially from strategies that manage withdrawal and psychoeducation about riskier gaming activities.
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Affiliation(s)
- Daniel L King
- School of Psychology, The University of Adelaide, Australia.
| | | | - John B Saunders
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Queensland, Australia
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Macey J, Hamari J. Investigating relationships between video gaming, spectating esports, and gambling. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.11.027] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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King DL, Herd MC, Delfabbro PH. Motivational components of tolerance in Internet gaming disorder. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.09.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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King DL, Herd MCE, Delfabbro PH. Tolerance in Internet gaming disorder: A need for increasing gaming time or something else? J Behav Addict 2017; 6:525-533. [PMID: 29137493 PMCID: PMC6034956 DOI: 10.1556/2006.6.2017.072] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background and aims The criterion of tolerance in DSM-5 Internet gaming disorder (IGD) refers to a need for increasing time spent gaming. However, this focus on "need for gaming time" may overlook some of the broader motivations, outcomes, or effects of gaming that underlie excessive play. This study aimed to explore regular and problematic gamers' experiences and perceptions of tolerance in IGD. Methods An online survey of 630 adult gamers yielded 1,417 text responses to open-ended questions. A thematic analysis of 23,373 words was conducted to extract dominant themes. Results Participants reported that they increasingly desired game items, status, or story progress as they became more involved or invested in games. As players develop higher standards of play in games, an increasing number of potential reward outcomes may have diminishing mood-modifying effects. None of the participants, including those with self-reported IGD, explicitly referred to a need for increasing time spent gaming. Discussion and conclusions These results suggest that players may be motivated by preferences for specific goals or reinforcers in games rather than wanting an amount of time spent gaming. Thus, problematic gaming may involve a need for completion of increasingly intricate, time-consuming, or difficult goals to achieve satisfaction and/or reduce fears of missing out. Further research is needed to determine whether these cognitive and motivational factors related to gaming stimuli should extend or replace the concept of tolerance in IGD or be considered as separate but related processes in disordered gaming.
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Affiliation(s)
- Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia,Corresponding author: Daniel L. King; School of Psychology, The University of Adelaide, Level 7, Hughes Building, Adelaide, SA 5005, Australia; Phone: +61 8 8313 3740; Fax: +61 8 8303 3770; E-mail:
| | | | - Paul H. Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
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Deleuze J, Nuyens F, Rochat L, Rothen S, Maurage P, Billieux J. Established risk factors for addiction fail to discriminate between healthy gamers and gamers endorsing DSM-5 Internet gaming disorder. J Behav Addict 2017; 6:516-524. [PMID: 29130328 PMCID: PMC6034950 DOI: 10.1556/2006.6.2017.074] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/17/2017] [Accepted: 10/22/2017] [Indexed: 02/02/2023] Open
Abstract
Background and aims The DSM-5 includes criteria for diagnosing Internet gaming disorder (IGD) that are adapted from substance abuse and widely used in research and clinical contexts, although evidence supporting their validity remains scarce. This study compared online gamers who do or do not endorse IGD criteria regarding self-control-related abilities (impulsivity, inhibitory control, and decision-making), considered the hallmarks of addictive behaviors. Method A double approach was adopted to distinguish pathological from recreational gamers: The first is the classic DSM-5 approach (≥5 criteria required to endorse the IGD diagnosis), and the second consists in using latent class analysis (LCA) for IGD criteria to distinguish gamers' subgroups. We computed comparisons separately for each approach. Ninety-seven volunteer gamers from the community were recruited. Self-reported questionnaires were used to measure demographic- and game-related characteristics, problematic online gaming (with the Problematic Online Gaming Questionnaire), impulsivity (with the UPPS-P Impulsive Behavior Scale), and depression (with the Beck Depression Inventory-II). Experimental tasks were used to measure inhibitory control (Hybrid-Stop Task) and decision-making abilities (Game of Dice Task). Results Thirty-two participants met IGD criteria (33% of the sample), whereas LCA identified two groups of gamers [pathological (35%) and recreational]. Comparisons that used both approaches (DSM-5 and LCA) failed to identify significant differences regarding all constructs except for variables related to actual or problematic gaming behaviors. Discussion The validity of IGD criteria is questioned, mostly with respect to their relevance in distinguishing high engagement from pathological involvement in video games.
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Affiliation(s)
- Jory Deleuze
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Filip Nuyens
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- International Gaming Research Unit, Nottingham Trent University, Nottingham, United Kingdom
| | - Lucien Rochat
- Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, Geneva, Switzerland
| | - Stéphane Rothen
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Joël Billieux
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
- Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
- Addictive and Compulsive Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, Rumpf HJ, Bowden-Jones H, Rahimi-Movaghar A, Chung T, Chan E, Bahar N, Achab S, Lee HK, Potenza M, Petry N, Spritzer D, Ambekar A, Derevensky J, Griffiths MD, Pontes HM, Kuss D, Higuchi S, Mihara S, Assangangkornchai S, Sharma M, Kashef AE, Ip P, Farrell M, Scafato E, Carragher N, Poznyak V. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. J Behav Addict 2017; 6:271-279. [PMID: 28816494 PMCID: PMC5700714 DOI: 10.1556/2006.6.2017.039] [Citation(s) in RCA: 230] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
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Affiliation(s)
- John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia,Corresponding author: John B. Saunders; Centre for Youth Substance Abuse Research, The University of Queensland, 1 Macquarie Street, Sydney, NSW 2000, Australia; Phone: +61 2 9252 0959; E-mail:
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiang Long
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Karl Mann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Mira Fauth-Bühler
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust and Division of Brain Science, Imperial College London, London, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Elda Chan
- Integrated Centre on Addiction Prevention and Treatment, Tung Wah Group of Hospitals, Hong Kong SAR, China
| | - Norharlina Bahar
- Department of Psychiatry and Mental Health, Hospital Selayang, Selangor, Malaysia
| | - Sophia Achab
- Mental Health and Psychiatry Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marc Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine, and Connecticut Mental Health Center, New Haven, CT, USA
| | - Nancy Petry
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Daniel Spritzer
- Study Group on Technological Addictions, Porto Alegre, Brazil
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Jeffrey Derevensky
- Applied Child Psychology and Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Halley M. Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Satoko Mihara
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Sawitri Assangangkornchai
- Epidemiology Unit and Centre for Alcohol Studies, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Manoj Sharma
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ahmad El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Emanuele Scafato
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Natacha Carragher
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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Billieux J, King DL, Higuchi S, Achab S, Bowden-Jones H, Hao W, Long J, Lee HK, Potenza MN, Saunders JB, Poznyak V. Functional impairment matters in the screening and diagnosis of gaming disorder. J Behav Addict 2017; 6:285-289. [PMID: 28816514 PMCID: PMC5700712 DOI: 10.1556/2006.6.2017.036] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 11/19/2022] Open
Abstract
This commentary responds to Aarseth et al.'s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in "moral panics around the harm of video gaming" and "the treatment of abundant false-positive cases." The ICD-11 Gaming Disorder avoids potential "overpathologizing" with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.
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Affiliation(s)
- Joël Billieux
- Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Sophia Achab
- Specialized Program in Behavioural Addictions, Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
- Research Unit Addictive Disorders, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, and Faculty of Medicine, Imperial College London, London, UK
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiang Long
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine and Connecticut Mental Health Center, New Haven, CT, USA
| | - John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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Starcevic V, Aboujaoude E. Internet Gaming Disorder, Obsessive-Compulsive Disorder, and Addiction. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0158-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kuss DJ, Griffiths MD, Pontes HM. DSM-5 diagnosis of Internet Gaming Disorder: Some ways forward in overcoming issues and concerns in the gaming studies field. J Behav Addict 2017; 6:133-141. [PMID: 28662619 PMCID: PMC5520128 DOI: 10.1556/2006.6.2017.032] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 05/28/2017] [Indexed: 02/02/2023] Open
Abstract
Background and aims The current DSM-5 diagnosis of Internet Gaming Disorder (IGD; American Psychiatric Association [APA], 2013) has led to a number of issues and concerns that we highlighted in our recent paper (Kuss, Griffiths, & Pontes, 2017). Experts in the field responded to our evaluation of these issues resulting in six commentaries. Methods In this paper, we offer responses to the six commentaries to move the scientific field forward. All of the responses to our original paper highlighted many conceptual, theoretical, and/or methodological problems with the proposed IGD diagnosis as outlined in the DSM-5. We outline some ways forward in overcoming issues and concerns in the gaming studies field. Results We argue that rather than stigmatizing gaming per se, the role of scientists and practitioners is to establish a clear-cut distinction between someone who may use games excessively but non-problematically and someone who is experiencing significant impairment in their daily lives as a consequence of their excessive gaming. This responsibility needs to be shared by popular media who are often quick to build a moral panic around gaming behaviors, often based on cherry-picking specific case studies and pieces of research which support their headlines. Conclusion Researchers, practitioners, gaming developers, and the media need to work together and collaboratively to build a realistic and comprehensive understanding of gaming as a normal, enjoyable, and often beneficial sociocultural practice, which for a small minority of excessive users may be associated with the experience of addiction-related symptoms that may require professional support.
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Affiliation(s)
- Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Halley M. Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Starcevic V. Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model. J Behav Addict 2017; 6:110-113. [PMID: 28301963 PMCID: PMC5520112 DOI: 10.1556/2006.6.2017.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and aims The paper "Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field" by Kuss, Griffiths, and Pontes (in press) critically examines the DSM-5 diagnostic criteria for Internet gaming disorder (IGD) and addresses the issue of whether IGD should be reconceptualized as gaming disorder, regardless of whether video games are played online or offline. This commentary provides additional critical perspectives on the concept of IGD. Methods The focus of this commentary is on the addiction model on which the concept of IGD is based, the nature of the DSM-5 criteria for IGD, and the inclusion of withdrawal symptoms and tolerance as the diagnostic criteria for IGD. Results The addiction framework on which the DSM-5 concept of IGD is based is not without problems and represents only one of multiple theoretical approaches to problematic gaming. The polythetic, non-hierarchical DSM-5 diagnostic criteria for IGD make the concept of IGD unacceptably heterogeneous. There is no support for maintaining withdrawal symptoms and tolerance as the diagnostic criteria for IGD without their substantial revision. Conclusions The addiction model of IGD is constraining and does not contribute to a better understanding of the various patterns of problematic gaming. The corresponding diagnostic criteria need a thorough overhaul, which should be based on a model of problematic gaming that can accommodate its disparate aspects.
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Affiliation(s)
- Vladan Starcevic
- Discipline of Psychiatry, Sydney Medical School – Nepean, University of Sydney, Penrith, NSW, Australia,Corresponding address: Vladan Starcevic; Discipline of Psychiatry, Sydney Medical School – Nepean, University of Sydney, PO Box 63, Penrith, NSW 2751, Australia; Phone: +61 2 4734 2585; Fax: +61 2 4734 3343; E-mail:
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King DL, Russell A, Gainsbury S, Delfabbro PH, Hing N. The cost of virtual wins: An examination of gambling-related risks in youth who spend money on social casino games. J Behav Addict 2016; 5:401-9. [PMID: 27648743 PMCID: PMC5264407 DOI: 10.1556/2006.5.2016.067] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background and aims Social casino games (SCGs) are not technically considered a form of gambling but they do enable players to spend money in a game that is gambling themed or structurally approximate to gambling. It has been theorized that SCGs could be a gateway to gambling activities or otherwise normalize the experience of gambling for young people, particularly when money becomes involved. The aim of this study was to investigate whether adolescents' financial expenditure in SCGs was associated with broader gambling activity, including level of participation, expenditure, and problem gambling symptoms. Methods An online survey was administered to 555 adolescents, including 130 SCG players (78 non-paying and 52 paying users). Results Paying SCG users tended to be employed males who play more frequently and engage in more SCG activities, who report more symptoms of problem gambling and higher psychological distress than non-paying SCG users. Paying SCG users reported more frequent engagement and spending in monetary gambling activities, and two-thirds of SCG payers recalled that their SCG use had preceded involvement in financial gambling. Discussion and conclusions Spending in simulated gambling activities by adolescents may be a risk factor for problem gambling. Although SCGs may currently defy classification as a form of gambling, these activities will likely continue to be scrutinized by regulators for the use of dubious or exploitative payment features offered in a gambling-themed format that is available to persons of all ages.
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Affiliation(s)
- Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, Australia,Corresponding author: Daniel L. King; School of Psychology, Level 4, Hughes Building, The University of Adelaide, Adelaide, SA 5005, Australia; Phone: +61 8 83133740; Fax: +61 8 8303 3770; E-mail:
| | - Alex Russell
- Centre for Gambling Education and Research, Southern Cross University, Lismore, Australia
| | - Sally Gainsbury
- Centre for Gambling Education and Research, Southern Cross University, Lismore, Australia
| | - Paul H. Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Nerilee Hing
- School of Human, Health and Social Sciences, Central Queensland University, Bundaberg, QLD, Australia
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Trajectories of abstinence-induced Internet gaming withdrawal symptoms: A prospective pilot study. Addict Behav Rep 2016; 4:24-30. [PMID: 29511720 PMCID: PMC5835835 DOI: 10.1016/j.abrep.2016.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/08/2016] [Accepted: 06/08/2016] [Indexed: 11/20/2022] Open
Abstract
Internet Gaming Disorder (IGD) is positioned in the appendix of the DSM-5 as a condition requiring further study. The IGD criteria refer to withdrawal symptoms, including irritability, anxiety, or sadness, that follow cessation of Internet gaming (APA, 2013). The aim of this study was to prospectively examine the nature of Internet gaming withdrawal symptoms, if they occur, under gaming abstinence conditions. This study employed a repeated-measures protocol to examine the cognitive-affective reactions of participants undertaking an 84-h Internet gaming abstinence period. The sample included individuals who met the IGD criteria as well as those who regularly played Internet games but did not meet the IGD criteria. Outcome variables included affect (positive and negative), psychological distress (depression, anxiety, stress), and Internet gaming withdrawal symptoms (craving/urge, thoughts about gaming, inability to resist gaming). A total of 24 participants (Mage = 24.6 years, SD = 5.8) were recruited from online gaming communities, and completed a series of online surveys before, during, and after abstaining from Massively Multiplayer Online (MMO) games. Both the IGD group and the non-IGD group experienced an abstinence-induced decline in withdrawal symptomatology, negative affect, and psychological distress. The IGD group experienced its largest decline in withdrawal symptomatology within the first 24 h of abstinence. These preliminary data suggest that gaming withdrawal symptoms may follow, at least initially, negative linear and quadratic trends. Further prospective work in larger samples involving longer periods of abstinence is required to verify and expand upon these observations.
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